How Your Board Can Improve the Patient Experience

Leadership begins at the top of the organization. Not exactly a profound statement, but many who say it fail to factor in the role of an organization’s board of directors, choosing instead to look at the CEO and executive team at the top of the org chart.

At Virginia Mason, the board has been a partner in leadership. I will never forget the moment early in my tenure as CEO when our board asked our leadership team a pretty straightforward question during a strategic planning session: “Who’s your customer?”

All of us felt pretty confident we provided the correct answer: “It’s the patient.” Then the board asked us to look closer to make sure our actions supported this response. We dove deeply into our processes around the organization and were pretty stunned when we discovered that most of them were designed around physicians, nurses, and other team members — not the patient. For example, what are waiting rooms but places for patients to hurry up, be on time, and then wait for us? And what happens in most hospitals on the weekend? Patients wait for Mondays so things can get done.

We found we weren’t designing our processes around our patients, our true customers.

We dove deeply into our processes around the organization and were pretty stunned when we discovered that most of them were designed around physicians, nurses, and other team members — not the patient.”

That revelation was the dawn of a journey we’ve been on for the past 15 years. We work to put the patient at the center of everything we do. Our strategic plan now is illustrated by a pyramid with the patient at the top. This has served as our true north ever since.

For example, we redesigned our medical clinics to eliminate waiting rooms. When patients arrive at our Kirkland Medical Center, they are immediately ushered to an exam room.

Our customer emphasis continues to be a cue for me, as a leader, when faced with myriad decisions every day. “How does this improve the experience for patients in our care?” is a question I am routinely asking myself and others in the medical center.

To further strengthen our focus on patients and the experience they have while in our care, our board requests that a patient or family member attend every meeting and share their stories. In fact, the board prefers that we try to share more negative patient experiences than positive ones as a way to improve. Examples include poorly coordinated care or inadequate follow-up, which, fortunately, are increasingly rare occurrences.

The patient connection is strengthened during leader rounding. The inclusion of executive leaders and board members in patient rounding is a staple of daily management at Virginia Mason. When our patients and frontline team members are visited not only by physicians, but also by the CEO and board, it sends a strong message that our leadership is fully invested in understanding the care experience and how it can be improved.

Within the past few years, we also launched a Patient-Family Partners program. Today, more than 150 patients and family members serve alongside our team members during planning, visioning, and improvement work. Their time, energy, and ideas are truly gifts to our organization and contribute to our goal to create full partnership with patients and families to improve and transform our delivery of care.

I urge all hospital and health system executives, physician leaders, and board members to ensure that the board of directors plays a role in ensuring the best patient experience possible. This is what true leadership in health care is all about.

Zuckerberg San Francisco General Hospital deployed its new leadership culture, which emphasizes staff decision-making, self-reflection, and clarity in defining problems and goals, to successfully address a crisis involving record-high patient volumes.